Abstract:
Background: Although pain relief is a key component of modern obstetric care, it remains a poorly
established service in sub-Saharan countries, such as Kenya. Maternal health care providers have an
extensive role to play in meeting the analgesic needs of women, during childbirth. This study sought to
examine the practice of labour pain relief and its deterrents among Kenyan maternal health care
providers.
Methods: This was an institution based, cross-sectional, descriptive survey. The study population
included midwives, obstetricians, and anaesthesiologists working at the second largest tertiary facility in
Kenya. A structured, self- administered questionnaire was used. The patterns of analgesic provision
during labour, knowledge, attitude, and perceived barriers to labour pain management were described.
Results: One hundred and seventeen respondents participated in the study, with a response rate of 97.5%.
The prevalence of routine labour analgesia provision was 61.5%. The most common pharmacological
method prescribed was non-opioids (13.4 %). Regional analgesia was provided by 4 (3.6%) of the
respondents. Sex, cadre, and years of experience were signicantly associated with the routine provision
of labour analgesia. The majority of maternal healthcare providers (53.0%) had poor knowledge of labour
pain management. Almost all (93.9%) of the respondents had a positive attitude towards the provision of
labour analgesia. The non-availability of drugs and equipment (58.1%), lack of clear protocols and
guidelines (56.4%), and absence of adequate skilled personnel (55.6%) were reported as the health
system factors that hindered the provision of labour analgesia.
Conclusions: More than half of maternal health care providers routinely relieved labour pain. Epidural
analgesia is still relatively underutilized. There is a need for the development of institutional labour pain
management protocols, to meet the analgesic needs of women during childbirth.